Rusheen's Yoga Centre BOOKING FORM

BOOKING FORM


Name: .......................................................... E Mail: ..........................................................	Contact number: ............................................ Session Dates: ...................................
Address:.................................................................................................................................. .................................................................................................................................
Date of Birth:................................................	Male Female
Previous if any Yoga experience :
Please note any relevant medical history (e.g. heart, respiratory, blood pressure, arthritis, back/neck problems, pregnancy, detached retina, recent surgery, etc.) and any medication you are currently taking. Please indicate if you have any special dietry requirments below. Please print and return this form along with your 50% deposit to: Rusheens Yoga Centre, Ballygriffin, Kenmare, Co Kerry, Ireland